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AAP looks at successes, challenges during COVID pandemic

May 20, 2024

Editor’s note: For the latest news on COVID-19, visit

The COVID-19 pandemic highlighted the AAP’s role as a trusted voice for children that can adapt quickly. However, it also took a toll on the mental health and well-being of children and pediatricians and emphasized the need for equity and more resources for pediatric health care.

The AAP looks back at the pandemic four years after it began in a new Pediatrics article “Successes and Lessons Learned in Responding to the Needs of Pediatricians, Children, and Families During the COVID-19 Pandemic.” 

“To be prepared for future pandemics, the AAP must leverage the lessons learned during the COVID-19 pandemic and its aftermath to advocate for significant investments in child health and the nation’s child health infrastructure,” the AAP wrote.

Impact on children

At least 15.6 million children contracted COVID from early 2020 through the end of the public health emergency in May 2023. At least 109,048 were hospitalized and 1,785 died, and these effects disproportionately impacted children who are Black, Hispanic, American Indian or Alaska Native.

The impact of the pandemic went far beyond physical health, disrupting every aspect of life. Children had to adapt to remote learning and the lack of support services they typically received at school. They experienced social isolation, anxiety about their family’s health, the trauma of losing loved ones and the stress of their family’s financial troubles.

These stresses exacerbated existing mental health struggles, leading the AAP and its partners to declare a national emergency in child and adolescent mental health.

Impact on pediatricians

During the pandemic, pediatricians dealt with exposures to the virus and the possibility of bringing it home to their families. They struggled with mental health and well-being as they grappled with financial losses, lack of resources, loss of staff, patients avoiding in-person care, balancing child and elder care, and backlash from people who refused masks and vaccines.

Still, there were opportunities that sparked positive changes, including the use of telehealth, online platforms for meetings and education, large-scale outdoor vaccination clinics and changes to operating hours and staffing.

AAP pandemic response

The AAP moved quickly to form an internal working group in early 2020 to manage the response to the virus. Throughout the pandemic, the AAP provided guidance, resources, education and advocacy.

The AAP collaborated with the Children’s Hospital Association to produce weekly reports on pediatric COVID cases, hospitalizations and deaths. As information changed rapidly, the AAP kept members informed through email, message boards, weekly meetings with chapter leaders, town hall meetings and more than 550 AAP News articles.

“That was a critical thing we did during that time was to communicate, communicate, communicate,” said AAP Past President Sara “Sally” H. Goza, M.D., FAAP (2020). “And I think we’ve learned different ways to do that and better ways to do that.”

Throughout the pandemic, the Academy released interim guidance on 28 topics, including clinical care, vaccines, safe return to schools, return to sports and use of face masks. It also implemented training programs for members and developed resources for families, including 298 articles.

The AAP advocated at all levels of government for things like funding for clinicians and vaccines for children and adolescents. Once vaccines were authorized, the organization pushed for equitable distribution and created a dosing guide to help clarify complex recommendations.

In addition to seeing patients, AAP members testified before Congress, conducted clinical trials, provided credible information in media interviews and wrote journal articles.

Lessons learned

The AAP details seven lessons learned during the pandemic:

  1. Pediatricians and pediatric health care are underresourced.
  2. The AAP has a trusted role as a voice for children’s unique needs because of its strong reliance on evidence and scientific expertise.
  3. The AAP can adapt quickly in an emergency, even in times of uncertainty, to create necessary interim guidance for pediatricians, public health, schools and families.
  4. The pandemic took a huge toll on the emotional and mental health and well-being of children.
  5. Equity is a fundamental value of AAP work and must be integral to all of it, including addressing and responding to health emergencies.
  6. The pandemic, combined with ongoing undervaluation of pediatrics, has negatively affected the well-being of the pediatric workforce.
  7. We are strongest together.

Dr. Goza said the pandemic highlighted the importance of keeping children front and center.

“The biggest lesson is that if we’re not out there talking about children … then people aren’t thinking about children,” Dr. Goza said. “Whether it’s pandemic or ‘normal’ times, we need to be out there trying to make the case because there are always things children need.”

Continuing efforts, preparation for future pandemics

While the COVID-19 public health emergency ended in May 2023, the AAP remains focused on the child and adolescent mental health crisis, continuing academic and social challenges, pediatric workforce hardships and families’ loss of health insurance and income.

The AAP’s review also lays out the work that needs to be done to prepare for future pandemics, including:

  • supporting earlier inclusion of children in clinical trials,
  • increasing routine childhood immunizations,
  • reopening pediatric inpatient units,
  • ensuring appropriate payment for pediatric services,
  • addressing social factors that threaten child health and
  • combating mistrust of public health information.

“The AAP is dedicated to continuous evolution of its communications and support of both its membership and staff in order to inform pediatric care in the wake of the COVID-19 pandemic and prevent pediatric populations from being forgotten in future public health emergencies,” the AAP wrote. “Driven by the needs of pediatric populations and their caregivers, the AAP remains resolute in supporting its membership and staff, whose dedication throughout the COVID-19 pandemic was — and continues to be — invaluable to all infants, children, adolescents, and families.”



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